This Participant’s Release, Waiver, Indemnity & Assumption of Risk (“Waiver and Release”) shall be completed by, and signed by or on behalf of, each player, coach or other person, and all referees and other field judges, who enter the Southpointe Fieldhouse premises.  If the person is under 18 years old, this Waiver and Release is to be signed by a parent/guardian. 

I, the participant, or the participant's parent/guardian, understand the nature of sports and physical activities.  To participate in sports and physical activities, the participant represents that he/she is in good health and proper physical and mental condition.

Health and Wellness Representations:

I, the participant, or the participant’s parent/guardian, warrant and represent participant will not enter the premises at Southpointe Fieldhouse, or participate in sports or other physical activities at Southpointe Fieldhouse, if the participant:

  • has experienced any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell within the last 14 days;
  • has been tested for COVID-19 within the last 14 days, regardless of outcome;
  • has traveled internationally within the last 14 days;
  • has traveled, within the last 14 days, to a location within the United States where the Pennsylvania Department of Health recommends a 14 day quarantine upon return;
  • has been exposed to someone with symptoms listed above, and/or with a suspected and/or confirmed case of COVID-19, in the last 14 days; or
  • has tested positive for COVID-19, and has not yet been cleared as non-contagious by a medical professional, or other state or local health official.

I, the participant, or the participant’s parent/guardian, acknowledge and understand that it is solely my responsibility to verify each of the above qualifications as a prerequisite for each game/practice/day/session/activity at Southpointe Fieldhouse.  I also waive my right to participate in sports or other physical activities, and otherwise agree not to enter Southpointe Fieldhouse, in the event any of the above qualifications are applicable to me.   

Acknowledgment of COVID-19 Risk:

I, the participant, or the participant’s parent/guardian, acknowledge and understand the extremely contagious characteristics of COVID-19, and that Southpointe Fieldhouse, and Southpointe Management, LLC, cannot guarantee that participant and/or visitors will not become infected with COVID-19 from exposure at Southpointe Fieldhouse.  Participants and parents understand that the risk of exposure to, and/or infection with, COVID-19 may result from the actions, omissions, or negligence of other participants and visitors, including, but not limited to participant’s fellow and opposing team members, coaches, referees, trainers, managers, guests, and other invitees, or others that these individuals may have come into close contact with, who may or may not have participated in activities at Southpointe Fieldhouse, and who may or may not have been exhibiting symptoms of COVID-19.  In addition to the risks of exposure referenced herein, participant/parent further acknowledges and understands the possibility exists that not all Southpointe Fieldhouse visitors, participants, invitees or others fully understand and appreciate risks of COVID-19, or will have reviewed and signed the same or similar Waiver and Release.   

By signing this Waiver and Release participant and/or parent/guardian hereby acknowledges that the participation/experience at Southpointe Fieldhouse could result in exposure to, or infection with, COVID-19.  Participant and/or parent/guardian further acknowledges and understands that exposure to COVID-19 can result in serious and permanent physical, mental and psychological harm, up to and including the death of the participant and others.

Assumption of Risk:

Physical activity, by its nature, carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries or other health issues.  Specific injuries and risks vary from one activity to another.  In the current global pandemic caused by the illness known as COVID-19, the risks of physical activity, including physical proximity and contact with others, substantially increases the risks associated with the participant’s experience.  There is a potential for death, serious injury and property loss.  The risks include, but are not limited to, risks associated with COVID-19 as well as other risks of injury or death caused by terrain, facilities, temperature, weather, condition of athletes, equipment, vehicular traffic, actions of other people, including but not limited to participants, volunteers, spectators, coaches, event officials, other invitees and/or visitors. 

I have read the Assumption of Risk paragraph and know, understand and appreciate these and other risks that are inherent in the activities held at Southpointe Fieldhouse.  By signing the Waiver and Release, I hereby assert that my participation is voluntary, and that I knowingly assume all such risks of death, injury and/or property loss.   

Release, Waiver and Indemnity Agreement:

I, for myself, and/or parent/guardian if the participant is a minor, for the minor, and for all heirs, next of kin, personal representatives, successors and assigns, do hereby release, waive, discharge, covenant not to sue and agree to indemnify, save and hold harmless Southpointe Fieldhouse, Southpointe Management, LLC, and any of their officers, directors, independent contractors, employees, volunteers, event holders, event sponsors, event volunteers, shareholders and members, from all liability claims, demands, losses or damages claimed by, or on behalf of the participant, resulting from participant's illness, disability, personal injury, death, property damage, property theft or actions of any kind, including participant’s travel to and from Southpointe Fieldhouse, caused or alleged to be caused, in whole or in part, by  Southpointe Fieldhouse or Southpointe Management, LLC and/or any of their officers, directors, independent contractors, employees, volunteers, business invitees, event holders, event sponsors, event volunteers, shareholders and/or members, or otherwise.  I further agree that if, despite this Waiver and Release, I, the participant, or anyone on the participant's behalf, make a claim against any of the above named released parties, I will indemnify, save and hold harmless any of the above named released parties from any litigation expenses, attorney fees, loss liability, damages, or costs any may incur as a result of any such claim. 


The parties agree that controversies arising under this Agreement, or relating to an alleged breach thereof, shall be determined by arbitration in accordance with the current rules for the American Arbitration Association, in the Commonwealth of Pennsylvania, or at another location mutually agreed upon by the parties, with each party bearing its own legal fees and costs.  It is understood that such arbitration is final and binding upon the parties and, by executing this Agreement, the parties are waiving their rights to a jury trial or otherwise seeking damages in court.

Acknowledgment of Understanding:

I have read this Waiver and Release, fully understand its terms, and understand that I am giving up substantial rights, including the right to sue.  I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. 

Today's Date: September 28, 2022

First Participant's Name

First Name*

Last Name*

First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Parent or Guardian's Email Address


Confirm Email*
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Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.

By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.

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